tailieunhanh - Gãy xương của ngón tay

Gãy xương của ngón tay cái metacarpal thường NHẤT xảy ra tại cơ sở. Gãy xương có thể trở thành luận án chia nhỏ vào khớp-nội và ngoài khớp dạng. Gãy xương Intraarticular những thách thức Xử lý Bởi vì CHÚNG Có Xu hướng dịch chuyển biến dạng do lực lượng diễn xuất tại cơ sở của ngón cái. | Fractures of the Base of the First Metacarpal Current Treatment Options Adam D. Soyer DO Abstract Fractures of the thumb metacarpal occur most frequently at the base. These fractures can be subdivided into intra-articular and extra-articular types. Intraarticular fractures present treatment challenges because they have a tendency to displace due to deforming forces acting at the base of the thumb. An understanding of the anatomy biomechanics and fracture pattern will aid in deciding on the best treatment option for each fracture type. Surgical treatment is recommended for unstable fractures. Anatomic restoration of the articular surface in Bennett and Rolando fractures is not essential to obtain a good functional result. However reduction should be 1 mm or less to reduce the risk of radiographic arthritis. Malunion of these fractures may result in long-term disability. Closed reduction and percutaneous Kirschner-wire fixation is generally the appropriate treatment for a Bennett fracture. Rolando fractures can be treated with either open reduction and internal fixation or external fixation depending on the size of the fracture fragments. In the case of severely comminuted intra-articular fractures articular impaction has been implicated as one of the causes of post-traumatic arthritis. It is difficult to restore the articular surface in these injuries. Therefore external fixation can be considered when the fracture fragments are small and there is significant soft-tissue injury. J Am Acad Orthop Surg 1999 7 403-412 Approximately 25 of all metacarpal fractures occur in the thumb metacarpal with 80 of those occurring at the base. The Bennett fracture is the most Historically the treatment of extra-articular fractures has occasioned little debate. However considerable controversy has surrounded the treatment of intra-articular fractures of the thumb metacarpal base. Since 1882 when Bennett first described five cases of an Òintra-articularÓ fracture-dislocation